Program Descriptions and Accomplishments

Investigators supported by NIA’s Biology of Aging Program seek to better understand the basic biological mechanisms underlying the process of aging and age-related diseases. Basic biochemical, genetic, and physiological studies are carried out primarily in animal models, including both mammals and non-mammalian organisms (e.g., flies, worms, yeast). The program’s goal is to provide the biological basis for interventions in the process of aging, which is the major risk factor for many chronic diseases affecting the American population.

In FY 2008, NIA held a “Biology of Aging Summit” to review the program’s current research portfolio, identify areas of opportunity, and facilitate the formulation of cohesive and comprehensive plans for the future.

Budget Policy: The FY 2010 budget estimate for the Biology of Aging Program is $181.747 million, an increase of $1.930 million or 1.1 percent over the FY 2009 estimate. Program objectives for FY 2010 include plans to increase our understanding of the aging immune system, particularly through a new grant initiative established in partnership with the National Institute of Allergy and Infectious Diseases; develop new tools to track cell turnover and cell fates in humans and animal models; and continue the search for interventions that extend the lifespan through the Intervention Testing Program (ITP) and other efforts. The ITP is an NIA-supported project investigating an array of treatments that have the potential to extend the lifespan and delay disease and dysfunction in a mouse model. This program is the primary mechanism through which NIA is working to achieve its GPRA goal “By 2012, identify at least one candidate intervention that extends median life span in an animal model.”

Behavioral and Social Research Program:
Understanding and Addressing the Behavioral, Emotional, and Social Dynamics of Aging

NIA’s Behavioral and Social Research Program supports social and behavioral research to better understand the processes of aging at both the individual and societal level. Research areas include the behavioral, emotional, and social changes individuals undergo throughout the adult lifespan; interrelationships between older people and social institutions; and the societal impact of the changing age composition of the population. The program also supports research training; development of research resources such as publicly available, cross-nationally comparable databases that support critical multidisciplinary behavioral and social research; and a knowledge base for the development of interventions to maximize active life and health expectancy. The program coordinates the highly successful Centers on the Demography and Economics of aging and Roybal Centers for Applied Gerontology. Both center programs will be renewed in FY 2009. The program also coordinates NIA’s Resource Centers for Minority Aging Research (RCMARs), a program whose objectives include increasing the diversity of the research on aging scientific workforce and the development of recruitment and retention strategies for minority aging research.

Budget Policy: The FY 2010 budget estimate for the Behavioral and Social Research Program is $177.384 million, an increase of $1.884 million or 1.1 percent over the FY 2009 estimate. Program objectives for FY 2010 include plans to continue major demographic studies that provide important insights into social and economic trends, including the Health and Retirement Study and, in partnership with the U.S. Census Bureau, the Federal Forum on aging; support development of comparable international data for cross-national analysis of institutional factors on health and well-being; support development of National Health Accounts to measure both the costs of health sector inputs and the value of health outcomes; continue to support research on U.S. disability trends, particularly through the newly established National Study of Disability Trends and Dynamics; support research initiatives to address financial challenges faced by American elders; and support research on behavioral processes at the individual level related to the preservation of social integration, cognitive abilities, health, and well being.

The aging of the American population will have profound implications for economic activities at the individual, local, national, and even global levels. What factors influence financial planning and retirement decisions among older adults? How will changes in the Nation’s demographic makeup affect public and private retirement and health insurance programs? What impact will recent changes in Federal programs
such as Medicare have on retirees? What are the interrelationships between health and economic status – and what are the implications of these relationships?
NIA-supported investigators explore these and related questions through a robust program of research on the economics of aging. Studies in this area focus on a variety of themes. For example, NIA supports a rich set of analyses related to Medicare, including research on the Part D prescription drug program and the impact on expenditures and health when people move from uninsured status onto Medicare.
A new solicitation to stimulate the development of models for forecasting Medicare expenditures or to provide insight into key aspects of that forecasting will be active in FY2010. Because the circumstances under which they retire are critical to the well being of older adults, NIA supports research to develop comprehensive econometric models of retirement that account for wealth, social programs, health, and family factors. Because cross-national analyses provide unique opportunities to weigh the impact of institutions on health and well being, NIA also supports work to harmonize international data sources along with innovative longitudinal data from U.S. sources such as the Health and Retirement Study. NIA has also supported research on automatic enrollment in 401(k) retirement savings that has informed public policy and will continue to encourage development of behavioral economics interventions to improve health and well being in retirement. Along these lines, NIA has initiated an interdisciplinary effort
linking economics, psychology, and neuroscience to explore the social, emotional, and cognitive processes and neurobiological mechanisms that underlie economic decisions.

NIA supports research center programs aimed at facilitating research in critical areas. This includes the Centers on the Demography and Economics of Aging program, established in 1994 to foster research in demography, economics, and epidemiology of aging and to promote the use of important datasets in the field. The many achievements of this program were recognized in September 2008 with the Heidelberg Award for Significant Contributions to the Field of Gerontology, a trienNIAl international competition. NIA’s Roybal Centers for Translational Research on Aging were established in 1993 to translate promising social and behavioral basic research findings, including demographic and economic research, into programs and practices that will improve the lives of older people and the capacity of institutions to adapt to societal aging. Both of these programs were recently renewed and will be active in FY2010.

NIA’s Neuroscience Program supports a broad spectrum of research and training aimed at better understanding age-related normal and pathological changes in the structure and function of the aging nervous system and how such changes affect behavior. The basic mission is to expand knowledge on the aging nervous system to allow improvement in the quality of life of older people. This includes basic and clinical studies of the nervous system, clinical trials of treatments and preventive interventions for neurological disease, and epidemiological research to identify risk factors and to establish prevalence and incidence estimates of pathologic conditions. Additionally, it supports research relevant to problems arising from psychiatric and neurological disorders associated with aging.

Budget Policy: The FY 2010 budget estimate for the Neuroscience Program is $441.317 million, an increase of $4.685 million or 1.1 percent over the FY 2009 estimate. Program objectives for FY 2010 include plans to continue to support a comprehensive research program on Alzheimer’s disease (AD) prevention, diagnosis, treatment, and care. Components of this program include a preclinical drug development program, a pilot trials initiative, the groundbreaking AD Neuroimaging Initiative, a Genetics Initiative to facilitate identification of genes that contribute to late-onset AD (the more common form of the disease), and a newly-established consortium to follow and evaluate individuals who are genetically predisposed to develop early-onset AD. In addition, NIA will continue to support research on normal changes in cognitive health that occur with age, particularly through ongoing participation in the NIH Cognitive and Emotional Health Project and the NIH Toolbox initiative on the development of brief and comprehensive assessment tools for cognitive and behavioral health, and will continue to support research on the neurobiology of aging, including studies of sensory and motor function; sleep and biological rhythms; the neural mechanisms underlying age-related changes in endocrine functions; neurodegenerative diseases of aging associated with infectious agents; and central nervous system, neuroendocrine system, and immune system interactions in aging.

Geriatrics and Clinical Gerontology Program:
Reducing Disease and Disability among Older People

As we age, our risk for many other types of disease and/or disability increases dramatically. NIA’s Geriatrics and Clinical Gerontology Program supports research on health, disease, and disability in the aged (other than neurodegeneration, which is the focus of the NIA’s Neuroscience Program). Areas of focus include age-related physical changes and their relationship to health outcomes, the maintenance of health and the development of disease, and specific age-related risk factors for disease. The program also plans and administers clinical trials. In addition, the program coordinates the Claude D. Pepper Older American Independence Centers Program, the goal of which is to increase scientific knowledge leading to better ways to maintain or restore independence in older persons. The eleventh Pepper center was established in FY 2008, and a twelfth will be established in FY 2009.

Budget Policy: The FY 2010 budget estimate for the Geriatrics and Clinical Gerontology Program is $138.973 million, an increase of $1.476 million or 1.1 percent over the FY 2009 estimate. Program objectives for FY 2010 include plans to continue studies of venous and arterial thrombosis, anemia, and other age-related conditions in the elderly. In partnership with the National Heart, Lung and Blood Institute, NIA will also support research to identify childhood factors that may exert a protective effect on health later in life. Finally, NIA will support studies on nutrition, weight loss and maintenance, and exercise in the elderly.

Program Portrait: Preventing Falls in Older Adults

FY 2009 level: $7,300,000
FY 2010 level: $7,400,000
Change: $ 100,000

Falls are the leading cause of both fatal and nonfatal injury in Americans ages 65 and older. They can result from multiple factors, including age-related changes to balance, gait, and physical strength. In a recent study, investigators at the Centers for Disease Control and Prevention estimated that approximately 5.8 million people age 65 or older, or 15.9% of all U.S. adults in that age group, fell at least once during the preceding three months, and nearly a third of those who fell sustained an injury that resulted in a doctor visit or restricted activity for at least one day. 1

NIA-supported researchers are conducting a number of studies aimed at reducing the incidence and severity of falls among older adults in the United States. For example, one study is attempting to determine the extent to which vitamin D insufficiency is associated with increased risk of falling. Another is examining the effects of outdoor neighborhood environmental characteristics (e.g., limited availability and poor features and condition of sidewalks, lack of walkable streets, poor maintenance of outdoor parks and recreation areas) on risk of outdoor falls among community-dwelling older people. The results of this study may suggest intervention strategies that could improve the living environment for older adults in the community. Other studies focus on development of strategies to improve strength, balance, and gait in the elderly.

Studies have also shown that although some effective interventions to prevent falls in the elderly have been identified, they are often underused. A recent study conducted by the NIA-supported Claude D. Pepper Older Americans Independence Center at Yale University found that a comprehensive health
promotion effort targeted at primary care clinicians and other health professionals who work with elderly patients was associated with a significant reduction in serious injuries from falls, suggesting that effective dissemination of information about fall prevention may reduce numbers of falls and serious injuries and underscoring the importance of health promotion efforts in public health and clinical practice.

NIA’s Intramural Research Program (IRP) includes the scientific disciplines of biochemistry, cell and molecular biology, structural biology, genetics, immunology, neurogenetics, behavioral sciences (psychology, cognition, and psychophysiology), epidemiology, statistics, and clinical research and the medical disciplines of neurobiology, immunology, endocrinology, cardiology, rheumatology, hematology, oncology, and gerontology. The program seeks to understand the changes associated with healthy aging and to define the criteria for evaluating when a change becomes pathologic. Studies focus on both common age-related diseases (e.g., Alzheimer’s disease, Parkinson’s disease, stroke, atherosclerosis, osteoarthritis, diabetes, cancer) and the determinants of healthy aging.

In FY 2009, the NIA IRP sustained a program of high-quality research on the basic biochemical and molecular underpinnings of aging and age-related diseases and conditions. In addition, IRP investigators conducted clinical research on a variety of conditions, including studies of the etiology of anemia, treatment trials for lymphoma, and studies to better understand several connective tissue disorders. In addition, work continued under the groundbreaking Baltimore Longitudinal Study of Aging, which celebrated its fiftieth anniversary in 2008.

Budget Policy: The FY 2010 budget estimate for the NIA’s Intramural Research Program is $112.367 million, an increase of $1.661 million or 1.5 percent over the FY 2009 estimate. Additional funds will be used to partially offset the costs associated with pay raises and other increases. Program objectives for FY 2010 include plans to determine the effectiveness of already available therapeutic agents for prevention in models of heart disease; for example, animal studies suggest that the compound fenoterol, widely used for treatment of pulmonary disease, may be effective in treatment of congestive heart failure, and other studies (also in animals) have shown that the drug erythropoietin, used to treat certain types of anemia, has a protective effect on the heart if administered shortly after a heart attack. An IRP clinical trial to establish the safety and efficacy of erythropoietin in humans who have suffered a heart attack was initiated in 2006 and is ongoing. In addition, the NIA IRP will continue to study the effects of obesity and sarcopeNIA on health outcomes through the Health, Aging, and Body Composition (Health ABC) study; continue to study the driving factors behind persistent black-white health disparities in overall longevity, cardiovascular disease, and cerebrovascular disease through the groundbreaking Healthy Aging in Neighborhoods of Diversity Across the Life Span (HANDLS) study; and identify genes associated with age-related changes to health and function through the SardiNIA project and the Age, Gene/Environment Susceptibility study.

In 2008, the world’s most comprehensive and longest running longitudinal examination of human aging celebrated an extremely productive fifty years of ground-breaking research that has transformed the field of geriatrics. Since its establishment in 1958, the NIA-supported Baltimore Longitudinal Study of Aging (BLSA) has provided a wealth of information on the physical consequences of aging and has helped distinguish changes related to aging from those due to disease, genetic makeup, environmental or lifestyle factors, or other causes.

The BLSA has been the first study to ask and attempt to answer the fundamental question “What is ‘normal’ aging?” Although there is still much to learn, BLSA findings have led us to two major conclusions. First, certain body changes and decline are a part of “normal” aging and do not necessarily lead to disease. And second, there is no single, chronological timetable of aging. We all age differently, and the rate of aging varies both for individuals over time and from one person to the next based on genetic, lifestyle, and disease processes. Although these two paradigms may seem like “common knowledge” today, they represent a radical departure from the conventional wisdom of the mid-twentieth century and have led to several changes in the way we have addressed the health of older Americans.

Over the past fifty years, BLSA scientists have produced a number of notable findings. For example, they found that, contrary to popular belief, people don’t naturally become cranky, depressed, or withdrawn as they age. In fact, an adult’s personality remains relatively stable after age 30. Another major BLSA finding has been the discovery of the relationship between PSA (prostate-specific antigen) levels and prostate cancer. BLSA scientists have also elucidated the relationship between age-related changes in the arteries and cardiovascular disease and distinguished normal age-related declines in cognitive ability from those associated with Alzheimer’s disease and related conditions.

In 2009, the BLSA will initiate the Insight into the Determinants of Exceptional Aging and Longevity (IDEAL) substudy to examine a spectrum of characteristics found present in individuals over age 80 who are living free of physical or cognitive disease. The study will help uncover mechanisms that are important to exceptional aging and how they might translate into actions that promote health and physical function in older adults.